Foveal microholes are a possible cause of unilateral or bilateral small central visual defects in the absence of other macular pathology. In 18 eyes of 17 patients we noted the following features: small, dark-reddish holes in the centre of the fovea ranging from 50 to 150 micron in size; normal adjacent retinal pigment epithelium and neuroepithelium; unilateral in most cases; males and females are equally affected; mean age 40 years; insidious onset; no history of direct eye trauma or sungazing; non-progressive; relatively favourable visual outcome; no relationship with regular macular holes; aetiology unknown. These distinctive features justify reporting these patients as an important separate group.